The Stability and Continuity of Medicaid Coverage
Authors: Leighton Ku
Journal: Annals of Internal Medicine (2022)

EditorialsJanuary 2023The Stability and Continuity of Medicaid CoverageLeighton Ku, PhD, MPHLeighton Ku, PhD, MPHThe George Washington University, Washington, DCAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-3315 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Although Medicaid is the nation's largest health insurance program, its coverage has historically been less stable than Medicare and employer-sponsored insurance, the other primary types of insurance. Medicare is essentially permanent after people become eligible at age 65 years, and employer coverage is generally stable as long as workers remain in the same job. But Medicaid beneficiaries could lose coverage for many reasons, such as if their incomes fluctuated above strict state income limits or if they lost status as children or pregnant women. In addition, onerous paperwork burdens also led to the loss of Medicaid even if people were ...References1. Ruff E, Fishman E. The return of churn: state paperwork barriers caused more than 1.5 million low-income people to lose their Medicaid coverage in 2018. Families USA. 16 April 2019. Accessed at https://familiesusa.org/resources/the-return-of-churn-state-paperwork-barriers-caused-more-than-1-5-million-low-income-people-to-lose-their-medicaid-coverage-in-2018 on 27 October 2022. Google Scholar2. Ndumele CD, Lollo A, Krumholz HM, et al. Long-term stability of coverage among Michigan Medicaid beneficiaries. A cohort study. Ann Intern Med. 2023;176:22-28. doi:10.7326/M22-1313 LinkGoogle Scholar3. Sugar S, Peters C, De Lew N, et al. Medicaid Churning and Continuity of Care: Evidence and Policy Considerations Before and After the COVID-19 Pandemic. Assistant Secretary for Planning and Evaluation, Office of Health Policy, U.S. Department of Health and Human Services. 12 April 2021. Accessed at https://aspe.hhs.gov/sites/default/files/private/pdf/265366/medicaid-churning-ib.pdf on 27 October 2022. Google Scholar4. Bindman AB, Chattopadhyay A, Auerback GM. Interruptions in Medicaid coverage and risk for hospitalization for ambulatory care-sensitive conditions. Ann Intern Med. 2008;149:854-60. [PMID: 19075204] doi:10.7326/0003-4819-149-12-200812160-00004 LinkGoogle Scholar5. Ku L, Steinmetz, E, Bysshe T. Continuity of Medicaid coverage in an era of transition. Association for Community Affiliated Plans. 1 November 2015. Accessed at www.communityplans.net/policy/continuity-of-medicaid-coverage-in-an-era-of-transition on 27 October 2022. Google Scholar6. Liu H, Ku L. Twelve-month continuous eligibility for Medicaid adults can stabilize coverage with a modest cost increase. RAND Blog. 9 December 2021. Accessed at www.rand.org/blog/2021/12/twelve-month-continuous-eligibility-for-medicaid-adults.html on 27 October 2022. Google Scholar7. Glied S, Swartz K. Stopping the “Medicaid churn”-addressing Medicaid coverage after the COVID-19 public health emergency ends. JAMA Health Forum. 2022;3:e224814. [PMID: 36326753] doi:10.1001/jamahealthforum.2022.4814 CrossrefMedlineGoogle Scholar8. Buettgens M, Green A. What will happen to Medicaid enrollees' health coverage after the public health emergency? Updated projections of Medicaid coverage and costs. Urban Institute. 9 March 2022. Accessed at www.urban.org/research/publication/what-will-happen-medicaid-enrollees-health-coverage-after-public-health-emergency on 27 October 2022. Google Scholar9. Goldman AL, Sommers BD. Among low-income adults enrolled in Medicaid, churning decreased after the Affordable Care Act. Health Aff (Millwood). 2020;39:85-93. [PMID: 31905055] doi:10.1377/hlthaff.2019.00378 CrossrefMedlineGoogle Scholar10. Ku L, Steinmetz E, Bruen BK. Continuous-eligibility policies stabilize Medicaid coverage for children and could be extended to adults with similar results. Health Aff (Millwood). 2013;32:1576-82. [PMID: 24019362] doi:10.1377/hlthaff.2013.0362 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Leighton Ku, PhD, MPHAffiliations: The George Washington University, Washington, DCDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3315.Corresponding Author: Leighton Ku, PhD, MPH, Department of Health Policy and Management, The George Washington University, 950 New Hampshire Avenue NW, Sixth Floor, Washington, DC 20052; e-mail, lku@gwu.edu.This article was published at Annals.org on 6 December 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLong-Term Stability of Coverage Among Michigan Medicaid Beneficiaries Chima D. Ndumele , Anthony Lollo , Harlan M. Krumholz , Mark Schlesinger , Jacob Wallace Metrics Cited byDuration and Continuity of Medicaid Enrollment Before the COVID-19 Pandemic January 2023Volume 176, Issue 1Page: 127-128KeywordsHealth insuranceMedicaidPrevention, policy, and public health ePublished: 6 December 2022 Issue Published: January 2023 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...